Emergency department visits by children with and without autism spectrum disorder: An initial comparison evaluating multiple outcome measures at one urban children's hospital

This study examined differences in the rates of psychiatric-related emergency department visits among adolescents with autism spectrum disorder, adolescents with attention deficit hyperactivity disorder, and adolescents without autism spectrum disorder or attention deficit hyperactivity disorder. Additional outcomes included emergency department recidivism, probability of psychiatric hospitalization after the emergency department visit, and receipt of outpatient mental health services before and after the emergency department visit. Data came from privately insured adolescents, aged 12–17 years, with autism spectrum disorder (N = 46,323), attention deficit hyperactivity disorder (N = 408,066), and neither diagnosis (N = 2,330,332), enrolled in the 2010–2013 MarketScan Commercial Claims Database. Adolescents with autism spectrum disorder had an increased rate of psychiatric emergency department visits compared to adolescents with attention deficit hyperactivity disorder (IRR = 2.0, 95% confidence interval: 1.9, 2.1) and adolescents with neither diagnosis (IRR = 9.9, 95% confidence interval: 9.4, 10.4). Compared to the other groups, adolescents with autism spectrum disorder also had an increased probability of emergency department recidivism, psychiatric hospitalization after the emergency department visit, and receipt of outpatient care before and after the visit (all p < 0.001). Further research is required to understand whether these findings extend to youth with other neurodevelopmental disorders, particularly those who are publicly insured.

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Epidemiology of Injury-Related Emergency Department Visits in the US Among Youth with Autism Spectrum Disorder

Journal of Autism and Developmental Disorders ◽

10.1007/s10803-016-2820-7 ◽

2016 ◽

Vol 46 (8) ◽

pp. 2756-2763 ◽

Cited By ~ 11

Author(s):

Luther G. Kalb ◽

Roma A Vasa ◽

Elizabeth D. Ballard ◽

Steven Woods ◽

Mitchell Goldstein ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Emergency Department ◽

Autism Spectrum ◽

Emergency Department Visits ◽

Spectrum Disorder ◽

The Us

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Examining frequent emergency department use among children and adolescents with autism spectrum disorder

Autism ◽

10.1177/1362361321990925 ◽

2021 ◽

pp. 136236132199092

Author(s):

Judith Beverly ◽

Theodoros Giannouchos ◽

Timothy Callaghan

Keyword(s):

Autism Spectrum Disorder ◽

Emergency Department ◽

Autism Spectrum Disorders ◽

Children And Adolescents ◽

Autism Spectrum ◽

Emergency Department Visits ◽

Spectrum Disorder ◽

Emergency Department Use ◽

Adolescents With Autism ◽

Spectrum Disorders

We analyze the 2011–2016 Healthcare Cost and Utilization Project State Emergency Department Databases and State Inpatient Databases for all emergency department visits by children and adolescents in New York to estimate the association between autism spectrum disorder and frequent emergency department utilization. Our study included 5.9 million individuals with 9.1 million emergency department visits. Of those, 31,682 had autism spectrum disorder (0.5%) accounting for 66,053 (0.7%) emergency department visits. Individuals with autism spectrum disorder had on average 0.6 more emergency department visits per year, were more likely to exhibit frequent emergency department use (⩾4, ⩾6, ⩾8, and ⩾10 emergency department visits/year), and had larger shares of comorbidities and diagnoses related to attention-deficit/hyperactivity disorder, intellectual disability, and epilepsy. These findings highlight the need for patient and family-centered care interventions and emergency department staff education initiatives. Lay abstract This study used data for 5.9 million individuals with 9.1 million emergency department visits from all hospitals in the state of New York to explore frequent emergency department use between children and adolescents with autism spectrum disorders and those without autism spectrum disorders. We found that children and adolescents with autism spectrum disorders had larger shares of comorbidities and diagnoses related to attention-deficit/hyperactivity disorder, intellectual disability, and epilepsy. Children and adolescents with autism spectrum disorders were also more likely to utilize emergency departments and to exhibit frequent use. These results emphasize the need for using family-centered care to improve the care experiences of children and youth with autism spectrum disorders and their families. In addition, the education of emergency department staff of processes and practices as it relates to delivery of care and the care experience.

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